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S314 ESTRO 35 2016

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correlation between the different variables and cardiac

damage is ongoing.

Poster: Clinical track: Breast

PO-0672

Ten years experience of breast reconstruction after

mastectomy in previously irradiated patients

A. Di Donato

1

Campus Bio-Medico University, Radiotherapy, Roma, Italy

1

, E. Ippolito

1

, R.M. D'Angelillo

1

, A. Sicilia

1

, E.

Molfese

1

, P. Trecca

1

, S. Ramella

1

, L. Trodella

1

, B. Cagli

2

, M.

Barone

2

2

Campus Bio-Medico University, Plastic and Reconstructive

Surgery, Roma, Italy

Purpose or Objective:

To evaluate the rate of complications

and the aesthetic outcome in previously irradiated patients

who underwent mastectomy and subsequent prosthetic

reconstruction in 2 times.

Material and Methods:

Eighty-three patients who underwent

immediate postmastectomy reconstruction with tissue

expander between January of 2003 and June of 2012 at the

Campus Bio-Medico University Hospital in Rome were

retrospectively divided into two groups: Group A (study

group) included 30 patients with previous quadrantectomy

and radiotherapy who underwent salvage mastectomy after

local recurrence and Group B (control group) included 53

patients submitted to primary radical mastectomy. Patients

and disease characteristics were analysed and complications

were correlated to treatment group.

Results:

The median follow-up time for the whole group was

36 months (range= 12-144 months). Between group A and

group B, there were no significant differences in terms of

age, body mass index, comorbidities, pathological stage,

treatments data (p=NS). In Group A 25/30 patients (83.33%)

completed heterologous reconstruction. In 5 patients

(16.67%) a conversion to combined or solely autologous

reconstruction was needed. In Group B, 52/53 patients

(98.11%) completed heterologous reconstruction. In 1 case

(1.88%) the expander was removed due to infection and an

autologous reconstruction was performed. Revision surgery

was needed in 5 patients (9.4%). Autologous salvage

reconstruction was more frequent for Group A patients

(relative risk 10.4, p=0.02). The overall rate of complications

was not different between the two groups (66.6% vs 58.5%;

p=0.49) even if major complications (vast necrosis of

mastectomy flaps with or without partial implant exposure,

with or without implant removal, all III and IV-degree

capsular contractures, either requiring or not requiring

further surgery) were non significantly higher in the

irradiated group (53.3% vs 32.0%; p= 0.07). However,

analysing capsular contracture, a significantly higher risk of

grade III-IV were recorded in Group A (40% vs 15%; relative

risk 3.75, p=0.02). In Group A the median time from RT to

reconstruction was 24 months (range= 9-192 months) and the

incidence of major complications was not related to time

from RT to reconstruction (p=0.313).

Conclusion:

Heterologus reconstruction after salvage

mastectomy in previously irradiated patients, is still possible

with satisfactory results.

PO-0673

Common European mitochondrial haplogroups in the risk of

RT-induced breast fibrosis

L. Deantonio

1

University Hospital Maggiore della Carità, Radiotherapy,

Novara, Italy

1

, S. Terrazzino

2

, S. Cargnin

2

, L. Donis

1

, C.

Pisani

1

, L. Masini

1

, G. Gambaro

1

, P. Canonico

2

, A. Genazzani

2

,

M. Krengli

1

2

University of Piemonte Orientale, Department of

Pharmaceutical Sciences, Novara, Italy

Purpose or Objective:

Germline polymorphisms in oxidative

stress response genes have been postulated to be involved in

the development of late normal tissue complications

following radiotherapy. Despite the key role of mitochondria

in the production of reactive oxygen species, the contribution

of mitochondrial DNA variations to clinical radiosensitivity is

still largely unknown. In the present study, we evaluated the

association between mitochondrial DNA haplogroups and the

risk of radiation-induced subcutaneous fibrosis after

postoperative radiotherapy in breast cancer patients.

Material and Methods:

Subcutaneous fibrosis was scored

according to the Late Effects of Normal Tissue-Subjective

Objective Management Analytical (LENT-SOMA) scale in 286

Italian breast cancer patients who received radiotherapy

after breast conserving surgery. Eight mitochondrial DNA

(mtDNA) SNPs that define the nine major haplogroups in the

European population were determined by PCR–RFLP analysis

on genomic DNA extracted from peripheral blood.

Results:

In a Kaplan-Meier analysis evaluated by the log-rank

test, carriers of haplogroup H were found at lower risk of

grade ³2 subcutaneous fibrosis (P=0.018). In the multivariate

Cox regression analysis adjusted for clinical factors (BMI,

breast diameter, adjuvant treatment, dose per fraction,

radiation type and acute skin toxicity), the haplogroup H

emerged as significant protective factor for moderate to

severe radiation-induced fibrosis (HR: 0.50, 95% CI 0.27-0.92,

P=0.027).

Conclusion:

Our results support a protective role of the

mitochondrial haplogroup H in the development of radiation-

induced fibrosis in breast cancer patients. Further

prospective studies with larger sample size and different

populations are nevertheless warranted to corroborate the

possible influence of mitochondrial haplogroups on late

normal tissue radiosensitivity.

PO-0674

Factors influencing patient reported cosmetic outcome:

results of the Young Boost Trial

P. Brouwers

1

MAASTRO clinic, Department of Radiation Oncology,

Maastricht, The Netherlands

1

, E. Van Werkhoven

2

, J. Van Loon

1

, P.

Poortmans

3

, H. Bartelink

2

, L. Boersma

1

2

The Netherlands Cancer Institute, Department of Radiation

Oncology, Amsterdam, The Netherlands

3

Radboud University Medical Center, Department of

Radiation Oncology, Nijmegen, The Netherlands

Purpose or Objective:

The Young Boost trial (YBT), a

multicenter RCT (NCT00212121), investigates whether a

higher boost dose leads to a lower recurrence rate in young

patients treated with breast conserving therapy. Cosmetic

outcome is the secondary objective. The aim of the current

analysis is to investigate the factors influencing the patients’

opinion about cosmesis.

Material and Methods:

From 2004-2011, 2421 breast cancer

patients ≤ 50 yrs were included in The Netherlands, France,

and Germany. All patients were treated with lumpectomy,

followed by 50 Gy whole breast irradiation. Patients were

randomized to receive a standard 16 Gy (n=1211) or a high 26

Gy boost (n=1210) to the tumour bed. Cosmetic outcome data

at 4 years of 807 patients were used for the current analysis

according to the following two scoring systems:

1. BCCT.core: Digital photographs were analyzed using a

software program to extract an overall cosmetic score:

excellent, good, fair or poor. This score is based on

symmetry, skin color and scar visibility. The 7 features of

symmetry in the BCCT.core program are: nipple position

(pBRA), level of lower breast contour (pLBC), level of nipple

(pUNR), distance from nipple to inframammary fold (pBCE),

length of breast contour (pBCD), area of the breast (pBAD)

and non-overlapping area between left and right breast

(pBOD). 2. Patients’ score using a validated patient’s

questionnaire about the breast appearance, including an

overall score: very satisfied, satisfied, not dissatisfied,

dissatisfied or very dissatisfied. First, we analyzed the 7

features of BCCT.core in a proportional odds model, to